Afzal Muhammad A, Ozgur Sacide S, Tagliaferri Ariana R, Bathobakae Lefika, Shamoon Fayez
Internal Medicine, St. Joseph's Regional Medical Center, Paterson, USA.
Cardiology, St. Joseph's Health, Paterson, USA.
Cureus. 2023 Mar 27;15(3):e36762. doi: 10.7759/cureus.36762. eCollection 2023 Mar.
Calcium channel blockers (CCBs) are the most prescribed medications in clinical practice. These drugs treat many conditions, including migraine headaches, vasospasms, abnormal heart rhythms, and hypertension. This widespread use, however, has also been linked with the increased incidence of CCB toxicity cases. CCB toxicity may be from accidental ingestion or iatrogenic. Patients may show signs of cardiovascular toxicity such as hypotension, bradyarrhythmia, coma, or even death. The treatment includes discontinuing the offending medication, securing the airway, and raising blood pressure. Herein, we report a rare case of a 40-year-old male with a history of uncontrolled hypertension and advanced kidney disease who experienced iatrogenic cumulative calcium channel blocker toxicity while switching CCB classes due to a hypertensive emergency with concomitant atrial flutter. Although uncommon in clinical practice, iatrogenic CCB toxicity is possible and equally lethal. Clinicians must be cautious when initiating these drugs, switching between oral and intravenous formulations, or switching from one class to another to avoid overdoses.
钙通道阻滞剂（CCB）是临床实践中处方量最多的药物。这些药物可治疗多种病症，包括偏头痛、血管痉挛、心律失常和高血压。然而，这种广泛使用也与CCB中毒病例的发病率增加有关。CCB中毒可能是由于意外摄入或医源性因素。患者可能会出现心血管毒性症状，如低血压、缓慢性心律失常、昏迷甚至死亡。治疗措施包括停用致病药物、确保气道通畅以及升高血压。在此，我们报告一例罕见病例，一名40岁男性，有未控制的高血压病史和晚期肾病，在因高血压急症伴发心房扑动而更换CCB类别时发生了医源性累积钙通道阻滞剂中毒。虽然医源性CCB中毒在临床实践中并不常见，但却是可能发生的，且同样具有致命性。临床医生在开始使用这些药物、在口服和静脉制剂之间转换或从一类药物转换到另一类药物时必须谨慎，以避免用药过量。
